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American Academy of Family Physicians (AAFP) Mandatory Influenza Vaccination of Health Care Personnel (HCP) |
| The AAFP supports annual mandatory influenza immunization for health care personnel (HCP) except for religious or medical reasons (not personal preferences). If HCP are not vaccinated, policies to adjust practice activities during flu season are appropriate (e.g. wear masks, refrain from direct patient care). |
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| Released: June 2011 |
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| American Academy of Pediatrics (AAP) Policy Statement: Influenza Immunization for All Health
Care Personnel: Keep It Mandatory |
| The purpose of this statement is to reaffirm the American Academy of Pediatrics'™ support for a mandatory influenza immunization policy for all health care personnel. With an increasing number of organizations requiring influenza vaccination, coverage among health care personnel has risen to 75% in the 2013 to 2014 influenza season but still remains below the Healthy People 2020 objective of 90%. Mandatory influenza immunization for all health care personnel is ethical, just, and necessary to improve patient safety. It is a crucial step in efforts to reduce health care associated influenza infections. |
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| Released: October 2015 |
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| American College of Physicians (ACP) Policy on Patient Safety and Health Care Provider Immunization |
For the safety of the individual health care provider (HCP), fellow HCPs, and the patients we serve, all HCPs should be immune to, or have received appropriate immunizations at the intervals recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, against the following transmissible infectious diseases, unless a medical contraindication exists, or a religious objection to immunization exists:
- Diphtheria
- Influenza
- Hepatitis B
- Measles/Mumps/Rubella
- Pertussis
- Varicella
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Background: In 2010, the Board of Regents (BOR) endorsed the following patient safety and quality of care initiative: An annual influenza vaccine should be required for every health care provider with direct patient care activities, unless a medical contraindication to influenza immunization exists, or a religious objection to immunization exists. ACP took a leadership position in endorsing this measure, and multiple other professional societies and academic as well as non-academic medical centers soon followed. |
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| Released: December 2013 |
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| American Hospital Association (AHA): AHA
Endorses Patient Safety Policies Requiring
Influenza Vaccination of Health Care Workers |
| To protect
the lives and welfare of patients and
hospital employees, the AHA's Board of
Trustees recently approved a policy
supporting mandatory patient safety policies
that require either influenza vaccination or
wearing a mask in the presence of patients
across health care settings during flu
season. This policy aims is to achieve the
highest possible level of protection. |
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| Released:
July 22, 2011 |
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American Medical Directors Association (AMDA) Position Statement: Mandatory Annual Influenza Vaccination for All Post-Acute and Long-Term Care Health Care Personnel |
| AMDA supports a mandatory annual influenza vaccination for every long-term health care worker, even those with indirect contact, unless a medical contraindication exists. |
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| Effective Date: August
9, 2018 |
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American Nurses Association (ANA) Position Statement on
Immunizations |
| All health care
personnel (HCP), including registered nurses (RNs),
should be vaccinated according to current
recommendations for immunization of HCP by the CDC and
Association for Professionals in Infection Control and
Epidemiology (APIC).
ANA supports exemptions from immunization only for the
following reasons:
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Medical contraindications
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Religious beliefs
All requests for
exemption from vaccination should be accompanied by
documentation from the appropriate authority to support
the request. Individuals who are exempted from
vaccination may be required to adopt measures or
practices in the workplace to reduce the chance of
disease transmission. Employers should ensure that
reasonable accommodations are made in all such
circumstances. |
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| Released: July 21, 2015 |
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| American Public Health Association (APHA)
Policy Statement: Annual Influenza
Vaccination Requirements for Health Workers |
| Key Points: |
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Urges providers, employers, and other
organizations to implement comprehensive
infection control programs that include
vaccination requirements along with
vaccination training and education,
respiratory protection, standard
respiratory precautions, and
housekeeping routines in keeping with
infection control standards. |
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Emphasizes that vaccination of health
workers is important not only for
patient safety but also for their own
protection and calls for strengthening
both the health sector's commitment to
safe working environments and its
capacity to achieve national goals for
protecting the health workforce from
influenza through education and
convenient access to employer-provided
vaccination. |
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Strongly recommends that institutions
that train health professionals, deliver
health care, or provide laboratory or
other medical support services require
immunizations for personnel at risk for
contracting or transmitting
vaccine-preventable illnesses. |
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Encourages institutional, employer, and
public health policy to require
influenza vaccination of all health
workers as a precondition of employment
and thereafter on an annual basis,
unless a medical contraindication
recognized in national guidelines is
documented in the worker's health
record. An educational component should
be created for health workers to learn
about vaccine safety science. |
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| Policy date: November 9,
2010 |
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| Association for Professionals in Infection
Control and Epidemiology, Inc. (APIC):
Influenza Vaccination Should Be a Condition
of Employment for Healthcare Personnel,
Unless Medically Contraindicated |
| Recommendation: Therefore, APIC recommends
that acute care hospitals, long term care,
and other facilities that employ healthcare
personnel require annual influenza
immunization as a condition of employment
unless there are compelling medical
contraindications. This requirement should
be part of a comprehensive strategy which
incorporates all of the recommendations for
influenza vaccination of HCP of the
Healthcare Infection Control Practices
Advisory Committee (HICPAC) and the Advisory
Committee on Immunization Practices (ACIP)
for influenza vaccination of HCP. An
essential part of this comprehensive
strategy includes strict attention to
important infection prevention practices
such as hand hygiene and respiratory
etiquette. Individuals exempted from annual
vaccination due to medical contraindications
must be educated on the importance of
careful adherence to all of the non-vaccine
related HICPAC prevention strategies,
including hand hygiene and cough etiquette.
Further, they may be required to wear a
surgical mask when contact with patients or susceptible employees is likely.
Additionally, strong leadership commitment
that takes into account and collaboratively
addresses concerns by employees and the
organizations representing them is essential
to providing the necessary support and
resources to implement such a comprehensive
program. |
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| Released:
February 2011 |
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| Infectious Diseases Society of America (IDSA): Mandatory Immunization of Health Care Personnel Against Influenza and Other Infectious Diseases |
| Because healthcare personnel (HCP) work in an environment where contact with patients or infective material from patients is routine, HCP are at risk for exposure to vaccine-preventable diseases and possible transmission to patients, their families, and other HCP. Vaccination programs are therefore an essential component of infection prevention and control. Preventing health care-associated transmission of influenza and other infectious diseases can protect patients, HCP, and local communities. For this reason, IDSA supports mandatory immunization of HCP according to recommendations of the Advisory Committee for Immunization Practices (ACIP) of the U.S. Centers for Disease Control and Prevention (CDC). |
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| Revised: December 2013 |
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National Association of County and City Health Officials (NACCHO): Influenza Vaccinations for Healthcare Personnel Policy |
| NACCHO urges healthcare employers and local health departments (LHDs) to require influenza vaccination for
all staff as a condition of employment. This mandate is necessary to achieve the Healthy People 2020 annual goal of 90 percent influenza
vaccine coverage for healthcare personnel. Healthcare personnel is defined as anyone who works or volunteers in a healthcare setting and/or
an LHD whose job may call for direct patient contact. |
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| Implementation date:
November 2012; Updated January 2017 |
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National Business Group on Health: Hospitals Should Require Flu Vaccination for all Personnel to Protect Patients’ Health and Their Own Health |
| Employees who invoke either of these exemptions should not engage in direct patient care if they have flu-like symptoms. When seemingly healthy, hospitals should either: |
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Reassign these employees to non-patient care areas; or |
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Require them to wear masks at all times during flu season when delivering care to patients |
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| Hospital personnel receiving annual flu vaccinations should include: |
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All personnel who receive a direct paycheck from the hospital facility; |
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Credentialed non-employees including licensed, independent practitioners affiliated with the hospital, but not necessarily on the payroll; and |
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Other non-credentialed, non-employee personnel including health professional students, volunteers, contract employees, construction workers, and medical or pharmaceutical vendors. |
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| Released: October 18,
2011 |
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National Patient Safety Foundation (NPSF) Supports Mandatory Flu
Vaccinations for Healthcare Workers |
| NPSF recognizes
vaccine-preventable diseases as a matter of patient safety and
supports mandatory influenza vaccination of health care workers to
protect the health of patients, health care workers, and the
community. NPSF appreciates that where vaccination is not possible
for any reason, due to unavailability or medical contraindications
of potential vaccine recipients, hospitals and healthcare
professionals must use all available alternatives to avoid
transmission to patients and coworkers including masks and
adjusting job responsibilities. |
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| Released: November 18, 2009; Reissued November 11, 2015 |
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| Society for Healthcare Epidemiology of America (SHEA) Position
Paper: Influenza Vaccination of Healthcare Personnel |
| SHEA views influenza vaccination
of HCP as a core patient and HCP safety practice with which
noncompliance should not be tolerated. It is the professional and
ethical responsibility of HCP and the institutions within which
they work to prevent the spread of infectious pathogens to their
patients through evidence‐based infection prevention practices,
including influenza vaccination. Therefore, for the safety of both
patients and HCP, SHEA endorses a policy in which annual influenza
vaccination is a condition of both initial and continued HCP
employment and/or professional privileges. The implementation of
this policy should be part of a multifaceted, comprehensive
influenza infection control program; it must have full, visible
leadership support with the expectation for influenza vaccination
fully and clearly communicated to all existing and applicant HCP;
and it must have ample resources and support to implement and to
sustain the HCP vaccination program. This recommendation applies
to all HCP working in all healthcare settings, regardless of
whether the HCP have direct patient contact or whether the HCP are
directly employed by the facility. It also applies to all
students, volunteers, and contract workers. SHEA recommends that
only exemptions due to recognized medical contraindications to
influenza vaccination be considered. |
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| Released: August 31, 2010; Revised October 2010 |
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Veterans Health Administration (VHA) Department of
Veterans Affairs |
| To prevent and control
seasonal influenza and its associated complications, the
Veterans Health Administration (VHA) requires a policy
and implementation guidance that will ensure VHA
achieves the Department of Health and Human Services (HHS)
Healthy People 2020 goal and The Joint Commission
standard of annual seasonal influenza vaccination of 90
percent of health care personnel (HCP). |
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| This directive
articulates the VHA policy requiring all HCP to
participate in the seasonal influenza prevention program
and outlines the key implementation steps. HCP covered
by the policy are expected to receive annual influenza
vaccination. Those HCP unable or unwilling to be
vaccinated are required to wear a face mask throughout
the influenza season. |
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| Released: September 26,
2017 |
ACIP Recommendations
Vaccine Information Statements 
